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Hernia occurs when the intestines slip through a breach in the abdominal wall, which usually occurs where there are no supporting abdominal muscles. It most often occurs in the groin and strikes men much more often than women. It is a consequence of prolonged gravity and the breakdown of connective tissue. The most serious complication occurs when the hernia is strangled in the abnormal opening. However, many hernias are asymptomatic and may not require treatment. A truss can be used but if strangulation is a possibility, the patient should have surgery.

The preperitoneal approach desirably and advantageously permits direct exposure to transversalis fascia without disturbing the inguinal canal structures and allows restoration of the integrity of this layer in an anatomical, tension-free, and sutureless manner. The essential feature of prosthetic versus nonprosthetic repair of inguinofemoral hernias is the replacement of the transversalis fascia by a large mesh that extends far beyond the borders of myopectineal orifice and thus rendering the actual repair of myopectineal orifice unnecessary. Therefore, the indications for preperitoneal prosthetic repair include all recurrent and multiply recurrent groin hernias, and bilateral hernias in older patients. [ABSTRACT FROM AUTHOR]

Discusses several issues related to medical practice. Controversies surrounding the reelection of a doctor from Tennessee as junior senator; Problems associated with prosthetic repair of incisional hernias; Complications of incisional hernioplasty with polyester mesh.